Facility Evaluation Report

Licensing Program Analyst (LPA) K. Hiratsuka, arrived at the facility unannounced to conduct an annual visit. LPA wore a surgical mask during visit. LPA observed caregivers wearing surgical masks during visit and LPA was screened at the entrance by the caregivers.

This facility has four resident rooms; two shared and two private. None of the rooms have exits to the outside. There is no staff room so the facility shall have 24 hour awake night staff. The main entrance opens into the hallway that has the resident rooms and locked laundry room. Directly to the left is a door that leads to the garage. To the right is a short hallway that leads to one shared room, one private room, and a full common bathroom that has a shower with nonskid floor and appropriate grab bars. On the right past the door leading to the garage is a private resident room with a full private bathroom. Past the short hallway on the right of the main entrance is another short hallway that leads to the right and the final shared resident room with a full private bathroom. The kitchen, dining, and main common area is located in the back of the facility. There is a sliding glass door leading to the outside. The kitchen has a locked cabinet for sharp knives. Laundry room has a locked cabinet for medications and small refrigerator for medications. There are gates on both sides of the facility.

Today LPA inspected staff and resident files

Today, LPA observed the following deficiencies:

-no staff training logs for required training for caregivers including medication training. Caregivers explained to LPA the training they received for medications, but there is no training log. There is no training logs for activities of daily living, personal rights, dementia, hospice, and other subjects required.